Articaine + Epinephrine - instructions for use, dose, side effects, contraindications

Epinephrine causes vasoconstriction at the site of injection, prevents the absorption of articaine, increasing the time of local anesthesia. By acting on beta receptors, epinephrine increases myocardial contractility, heart rate, increases conduction of the heart.

Pharmacokinetics:

Local anesthetic effect lasting 45 minutes, begins in 0,5-3 minutes after the administration of the drug.

The half-life is 1 minute. With intramuscular and subcutaneous injection, it is absorbed slowly, undergoes biotransformation in the liver, is eliminated by the kidneys by 55-60% within 6 hours.

Indications:

It is used for dental interventions and for conductive anesthesia according to Oberst. Used for correcting dislocations, suturing gaps in the perineum after childbirth.

ICD-10

XXI.Z00-Z13.Z01.2 Dental examination

XX.Y40-Y59.Y56.7 Drugs used locally in dental practice

Contraindications:

Bronchial asthma, methemoglobinemia, B₁₂-deficit anemia, paroxysmal ventricular tachycardia, angle-closure glaucoma.

Individual intolerance.

Carefully:

With a deficiency of cholinesterase, kidney failure, bronchial asthma.

Pregnancy and lactation:

Recommendations for FDA - Category C.

There is no information about ingestion in breast milk, nor is there any description of the negative impact on the baby.

Dosing and Administration:

Extraction of the teeth: submucosal injection of 1.5 ml per tooth.

When turning teeth for crowns, 0.5-1 ml per tooth, not more than 7 mg / kg.

Sewing of the perineal wounds: 5-15 ml.

Fracture correction: 5-20 ml.

Conducting anesthesia according to Oberst: 2-4 ml, intercostal - up to 4 ml per segment, paravertebral - up to 10 ml, peridural - up to 30 ml, paracervical - 10 ml in each side.

Use in children

Used for the purpose of anesthesia with dental manipulations from 4 years of age. From 4 to 12 years, the dose is adjusted depending on the body weight (not more than 5 mg / kg).From the age of 12, it is used in the same dosages as for adult patients.

The highest daily dose: for adults - 7 mg / kg (0.175 ml / kg), children under 12 years - 5 mg / kg.

The highest single dose: for adults - 7 mg / kg (0.175 ml / kg), children under 12 years - 5 mg / kg.

Side effects:

Central and peripheral nervous system: headache, impaired consciousness and breathing, tremor, convulsions.

Cardiovascular system: arterial hypotension, arrhythmia.

Digestive system: nausea, vomiting, diarrhea.

Sense organs: diplopia, transient loss of vision.

Local reactions: edema at the injection site, necrosis - with accidental ingestion of the drug into the vessels.

Allergic reactions.

Overdose:

Motor excitement, dizziness, collapsoid condition.

Treatment: discontinuation of drug administration, control of respiratory rate, heart rate and blood pressure.

With convulsive syndrome - intravenous (slow) administration of short-acting barbiturates with oxygen supply. When the patient is in a serious condition - endotracheal intubation, artificial ventilation, anti-shock measures. Contraindicated the introduction of central analeptics.

Interaction:

Vasoconstrictors increase and prolong the effect of articaine.

The use of the drug does not depend on the time of eating.

Special instructions:

Intravenous administration of the drug is inadmissible - it is necessary to perform an aspiration test!

The drug does not affect the fetus at any dosage and administration technique.

For multiple use of the drug on the label of the bottle, the date of dissection is marked - application after two days is prohibited. Opened ampoules are not subject to storage.

Instructions

Articaine + Epinephrine (Articainum + Epinephrinum)